The effect of subclassification of interstitial pneumonia and bronchiolitis obliterans on survival of patients registered for lung transplantation from brain-dead donors in Japan
Masaaki Satoa Kaori Matsudab Yoshinori Okadac Takahiro Otod Masato Minamie Naoya Yamasakif Takekazu Iwatag Ichiro Yoshinog Takeshi Shiraishih Masayuki Chidai Takeshi Nagayasuf Meinoshin Okumurae Takashi Kondoc Hiroshi Datea Shinichiro Miyoshid
aDepartment of Thoracic Surgery, Kyoto University Hospital
bDivision of Epidemiology, Department of Public Health and Forensic Medicine,
Tohoku University Graduate School of Medicine
cDepartment of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University
dDepartment of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry,
and Pharmacological Sciences
eDepartment of General Thoracic Surgery, Osaka University Graduate School of Medicine
fDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
gDepartment of General Thoracic Surgery, Chiba University Graduate School of Medicine
hDepartment of General Thoracic, Breast and Pediatric Surgery, Fukuoka University
iDepartment of General Thoracic Surgery, Dokkyo Medical University
Currently, “idiopathic interstitial pneumonia,” “other interstitial pneumonia,” and “bronchiolitis obliterans” are used as disease categories to register patients for lung transplantation from brain-dead donors in Japan. However, the latter two categories contain heterogeneous diseases because of inconsistent criteria applied by each center. Hypersensitivity pneumonitis and interstitial pneumonia secondary to collagen diseases are both presently categorized as “other interstitial pneumonia” and posthematopoietic stem cell transplantation lung injury is presently categorized as “bronchiolitis obliterans” or “other interstitial pneumonia,” depending on the patient's condition without solid criteria. The prognoses of these patients on the transplant waiting list were equally poor compared with idiopathic interstitial pneumonia. Although the number of patients who received lung transplantation was insufficient except for idiopathic interstitial pneumonia, there was a trend of good posttransplant survival in interstitial pneumonia; that of posthematopoietic stem cell transplantation lung injury tended to be poorer compared with pulmonary artery hypertension. When these results are considered, the priority of lung-transplant candidates in Japan needs further refinement.
Lung transplantation Interstitial pneumonia Bronchiolitis obliterans Waiting list Prognosis
Received 15 Dec 2014 / Accepted 2 Feb 2015
AJRS, 4(3): 210-215, 2015